CCRP Neuroendocrine

Expertise

The Neuroendocrine Oncology Program is a highly collaborative program devoted to bringing cutting-edge treatments to our patients. Although neuroendocrine neoplasms (NENs) are still rare diseases, we have more than 600 patient visits per year in our outpatient center– one factor contributing to the high patient accrual is the fact that the surgical department is the largest pancreatic cancer center in Europe continuously improving its operating techniques within multicenter trials (Diener, Lancet 2011).

A second factor is the close collaboration of our neuroendocrine tumor experts from gastrointestinal Surgery, Pathology, Endocrinology, Nuclear Medicine, Interventional Radiology, Gastronenterology and Radiation Oncology. The team selects the appropriate treatment plan within specialized tumor board meetings twice a week. Starting PRRT in 2003 with 100-150 Dotatoc therapies/year and radioembolisation since 2009 with up to 75 SIRT therapies/year we are one of the most experienced centers in Germany offering these new treatment options for NET patients in clinical routine and clinical investigations. In translational research we have shown that Chromogranin A fragments are able to regulate metastatic small intestinal NEN proliferation via the AKT pathway indicating that CgA plays a far more complex role in the biology of these tumors than previously considered (Giovinazzo /Schimmack, PLOS ONE). With respect to clinical trials we started to be successful in participating in multicenter RCTs in order to offer our patients new treatment options: e.g. a RCT multicenter trial testing the effect of telotristat etiprate, an orally-delivered small molecule that acts by inhibiting the enzyme tryptophan hydroxylase (TPH) to control symptoms in functional carcinoids.

A collaboration agreement with the European governmental institution: European Commission - Joint Research Centre – Institute for Transuranium Elements (EC, JRC, ITU) in Karlsruhe, to improve PRRT of neuroendocrine tumors by optimizing the radionuclide that can be tagged to somatostatin analogs. First results have already been honored by two Young Investigator Awards, one from the Society for Nuclear Medicine (SNM), one from the Radiologic Society of North America (RSNA) and one “Picture of the year” from SNM/JNM.

Established research collaboration with Gastrointestinal Pathobiology Research Group, Yale University School of Medicine, New Haven, USA that is working on diagnostic improvement in the detection of metastasis as well as understanding the molecular pathways driving tumor proliferation.